Provider Demographics
NPI:1306436951
Name:BRADY-SLOMKA, JILL M (PT)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:M
Last Name:BRADY-SLOMKA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6310 COLE RD
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-3736
Mailing Address - Country:US
Mailing Address - Phone:716-818-3790
Mailing Address - Fax:
Practice Address - Street 1:4071 HARDT RD
Practice Address - Street 2:
Practice Address - City:EDEN
Practice Address - State:NY
Practice Address - Zip Code:14057-9650
Practice Address - Country:US
Practice Address - Phone:716-992-4466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-18
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist